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May 2, 1998BMJ16 citationsOpen Access

Is cardiothoracic ratio in healthy middle aged men an independent predictor of coronary heart disease mortality? Whitehall study 25 year follow up

Harry Hemingway
Harry HemingwayPreventive Cardiology
MSMartin ShipleyUniversity of LondonDCD. ChristieThe Royal Melbourne Hospital

Structured PICO

Does increased cardiothoracic ratio independently predict mortality from coronary heart disease in healthy middle-aged men?

P
Population
1203 healthy middle-aged male British civil servants
I
Intervention
Increased cardiothoracic ratio (exposure)
O
Outcome
All-cause mortality and coronary heart disease mortalityhard clinical

This study investigates whether cardiothoracic ratio, a simple clinical measure of heart size, independently predicts long-term coronary heart disease mortality in healthy middle-aged men.

Abstract

Aetiological studies of myocardial ischaemia have tended to concentrate on factors which influence atherothrombotic processes in the coronary arteries rather than myocardial pathophysiology.1 The commonest clinical measure of heart size—cardiothoracic ratio—was included in the original Whitehall study of healthy middle aged civil servants. Cardiothoracic ratio is associated with left ventricular mass2 and left ventricular systolic function; since left ventricular mass determined by echocardiography has been shown to predict coronary heart disease in elderly people,1 we hypothesised that increased cardiothoracic ratio would independently predict mortality from coronary heart disease. Unlike previous studies3 we did not include mortality from stroke since it may be related to heart size through different pathophysiological mechanisms. View this table: Adjusted hazard ratios (95% confidence intervals) for the effect of cardiothoracic ratio on all cause and coronary heart disease mortality We studied the 1203 male British …

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Cite This Study

Hemingway et al. (1998) studied this question.

synapsesocial.com/papers/6a1bf488b33628da419d0aa5https://doi.org/10.1136/bmj.316.7141.1353
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Left ventricular hypertrophy1995 · 31 citations
  2. 2Value of Echocardiographic Measurement of Left Ventricular Mass in Predicting Cardiovascular Morbid Events in Hypertensive Men1986 · 1,095 citations
  3. 3Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method.1977 · 4,507 citations
  4. 4Physical Correlates of Radiologic Heart Volume1978 · 9 citations
  5. 5A comparison of objective measurements on the chest roentgenogram as screening tests for right or left ventricular hypertrophy1986 · 13 citations